chapter 9 review of the mental health and well-being …...health and well-being. to date, only one...
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175© The Author(s) 2019 M. R. Marselle et al. (eds.), Biodiversity and Health in the Face of Climate Change, https://doi.org/10.1007/978-3-030-02318-8_9
Chapter 9Review of the Mental Health and Well- being Benefits of Biodiversity
Melissa R. Marselle, Dörte Martens, Martin Dallimer, and Katherine N. Irvine
Abstract Little is known about the contribution that biodiversity has on mental health and well-being. To date, only one systematic review has investigated the health and well-being benefits from contact with biodiversity (Lovell et al. J Toxicol Environ Health B Crit Rev 17(1):1–20, 2014). The number of research studies investigating the health and well-being effects of biodiversity has increased since this publication. Here, we provide an update, focusing on the impact of biodiversity on mental health and well-being. Our objectives are to: (i) identify and describe the literature published after 2012; and (ii) synthesise all results from Lovell et al. (J Toxicol Environ Health B Crit Rev 17(1):1–20, 2014) and the more recently pub-lished literature to assess whether biodiversity influences mental health and well- being. Sixteen recently published studies met the inclusion criteria. The literature is varied with different study designs, measures of biodiversity, mental health and well-being. The synthesis of results was drawn from 24 studies: nine from Lovell et al. (J Toxicol Environ Health B Crit Rev 17(1):1–20, 2014) and 15 identified by this chapter. There is some evidence to suggest that biodiversity promotes better
M. R. Marselle (*) Department of Ecosystem Services, Helmholtz Centre for Environmental Research – UFZ, Leipzig, Germany
German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Leipzig, Germanye-mail: [email protected]
D. Martens Eberswalde University for Sustainable Development, Eberswalde, Germanye-mail: [email protected]
M. Dallimer Sustainability Research Institute, School of Earth and Environment, University of Leeds, Leeds, UKe-mail: [email protected]
K. N. Irvine Social, Economic and Geographical Sciences Research Group, The James Hutton Institute, Aberdeen, Scotland, UKe-mail: [email protected]
176
mental health and well-being. However, more studies reported non-significant results. The evidence is not yet of the extent necessary to characterise the role of biodiversity in relation to mental health or well-being. Future interdisciplinary research directions are discussed.
Keywords Mental health · Mental well-being · Biodiversity · Species richness · Synthesis · Review
Highlights• Research into the health and well-being effects of biodiversity has grown since
Lovell et al. (2014).• We update Lovell et al. (2014) and focus on the impact of biodiversity on mental
health and well-being.• 16 recently published studies on biodiversity and mental health and well-being
were identified.• Synthesis of results found some evidence that biodiversity promotes better men-
tal health and well-being.• Overall, more studies reported non-significant effects.
9.1 Introduction
Contact with natural environments facilitates diverse health and well-being benefits (Bowler et al. 2010; Frumkin 2001; Hartig et al. 2014; Irvine and Warber 2002; Keniger et al. 2013). However, in this body of research the natural environment is often “treated as uniform” (Dallimer et al. 2012, p. 48), as studies commonly com-pare broad urban and natural environment categories (e.g. Hartig et al. 2003; Korpela et al. 2016) or analyse the amount of, or proximity to, green space (e.g. Groenewegen et al. 2012; Triguero-Mas et al. 2015). Whilst a substantial amount of literature investigates the impact of nature or green space on health and well-being, little is known about the contribution that different qualities of the natu-ral environment, such as biodiversity, have on mental health and well-being.
Systematic reviews of the mental health or well-being benefits from contact with nature do not include studies that assess the biodiversity of the natural environment (e.g. Bowler et al. 2010; Dadvand et al. 2015; Thompson Coon et al. 2011). This same body of literature on the mental health or well-being effects of nature is also present in systematic reviews of the health benefits of biodiversity (e.g. Horwitz and Kretsch 2015; Hough 2014; Whitmee et al. 2015), resulting in a closed loop of examined literature. To date, only one systematic review has explicitly investigated the health and well-being benefits from contact with biodiversity (Lovell et al. 2014). While the authors found some evidence for a positive benefit from exposure to biodiversity, overall, the synthesis of 15 quantitative studies showed no clear pat-tern of results for the effects of biodiversity on human health and well-being.
M. R. Marselle et al.
177
Since the publication of Lovell et al. (2014), interest has grown in the potential contribution of biodiverse environments for health and well-being. Growth in this field is shown clearly by the increase in the number of related scientific publica-tions. For example, a search in the Web of Science on just one term, ‘biodiversity and health’, yielded 0 hits for 1980–1989, 3 hits for 1990–1999, 2 hits for 2000–2009, 6 hits for 2010–2013, and 16 hits from 2014–2018. This coincides with increased interest from governments and international organisations on the men-tal health and well-being effects of biodiversity (Convention on Biological Diversity 2017a, b; EKLIPSE 2017; WBGU – German Advisory Council on Global Change 2016; World Health Organisation & Secretariat of the Convention on Biological Diversity 2015). Given this research expansion and increased interest, in this chapter we update the literature reviewed by Lovell et al. (2014). In particular, we focus on the relationships between biodiversity and mental health and mental well-being, as such an analysis has yet to be conducted. Box 9.1 details these definitions.
The aim of this chapter is to identify, summarise and synthesise research on the impact of biodiversity on mental health and well-being. There are two objectives:
1. Describe the state and nature of the body of evidence, published since the review by Lovell et al. (2014), relating biodiversity to mental health and well-being;
2. Provide a synthesis of results from Lovell et al. (2014) and the more recently published literature to assess whether biodiversity influences mental health and well-being.
Box 9.1: Definitions of Biodiversity, Health, Mental Health and Mental Well-being• Biodiversity is “the variability among living organisms from all sources
including, inter alia, terrestrial, marine and other aquatic ecosystems and the ecological complexes of which they are part; this includes diversity within species, between species and of ecosystems” (United Nations Convention on Biological Diversity 1992, p. 3).
• Health is “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (World Health Organization 1946).
• Mental health “a state of well-being in which an individual realises his or her own abilities, can cope with the normal stresses of life, can work pro-ductively and is able to make a contribution to his or her community” (World Health Organization 2016).
• Mental well-being is “the psychological, cognitive and emotional quality of a person’s life. This includes the thoughts and feelings that individuals have about the state of their life, and a person’s experience of happiness” (Linton et al. 2016, p. 12).
9 Review of the Mental Health and Well-being Benefits of Biodiversity
178
9.2 Methods
9.2.1 Literature Review
A systematic search strategy was used to identify published, peer-reviewed studies that specifically examined relationships between biodiversity and mental health or mental well-being outcomes. The literature search was conducted in October 2017, following a replicable procedure (Koricheva et al. 2013). Inclusion criteria (Box 9.2) was identical to those used by Lovell et al. (2014), except with a focus on literature published (i) between 2013 and September 2017, and (ii) in any language. Thus, we are building on, rather than replicating, the review by Lovell et al. (2014).
Literature was identified through structured searches of the Web of Science, which identified 189 articles (see the Appendix for the search terms). One reviewer [MM] initially screened titles and abstracts, with a second reviewer [DM] applying the inclusion criteria to articles that needed a second opinion. Nineteen articles were identified as eligible for full text review (see Fig. 9.1). Backward and forward refer-ence searches (Cǒté et al. 2013) were conducted on these 19 articles. The resulting 1610 articles were first screened by year and title for eligibility, then abstracts were read. This method identified an additional four articles, all from forward citations. Backward and forward reference searches of these four articles resulted in an addi-tional 242 references, which underwent a similar screening process. No new articles were identified. Twenty-three articles underwent full text screening (by MM and
Box 9.2: Study Inclusion Criteria (Adapted from Lovell et al. 2014) 1. Any peer-reviewed study, published between January 2013 and September
2017 2. Any recognised and reliable study design, with any population group, from
any country and in any language 3. An explicit consideration of biodiversity, species richness and/or a setting
protected because of its biodiversity, and 4. An explicit consideration of either a primary health-related outcome
including any self-reported or objective measure of mental health or men-tal well-being, or a secondary health-related outcome including self-report or objective measures of physical activity or self-report social cohesion.
Exclusion criteria: Studies were excluded if they did not assess (i) biodi-versity and (ii) mental health, mental well-being, physical activity and social cohesion related outcome measures. Studies assessing preferences, physio-logical outcomes, use/visitation, the amount of green space without specifica-tion of its biodiversity, or physical activity without identification of where it occurred were excluded. Studies not reporting primary research (e.g. review papers) were also excluded.
M. R. Marselle et al.
179
DM); seven were excluded primarily because they did not assess biodiversity, mental health, mental well-being, physical activity or social cohesion. In total, 16 articles were identified (see Table 9.1).
9.2.2 Characteristics of the Recent Literature
To describe the recently published literature on biodiversity and mental health and well-being, a standardised data extraction form was used to record relevant informa-tion from the 16 studies: country of origin, participants, theoretical position, biodi-versity indicators, outcome measures, contact with biodiverse environment, moderators, mediators and results.
Biodiversity indicators were classified on the basis of biodiversity levels identi-fied by Botzat et al. (2016) – namely, ecosystems/habitats (e.g. parks, forests); spe-cies communities (e.g. plants, birds, butterflies); or single species. Within the species community level, both species richness (e.g. the number of different bird species) and abundance of a specific taxonomic group irrespective of species (e.g. the num-ber of all birds) were identified. Both variables have been shown to have differential effects (Hedblom et al. 2017). Abundance may be more important to mental health or mental well-being than the number of different species (Dallimer et al. 2012).
Fig. 9.1 Process of literature review and identified relevant articles
9 Review of the Mental Health and Well-being Benefits of Biodiversity
Tabl
e 9.
1 St
udy
char
acte
rist
ics
of th
e 24
stu
dies
ass
essi
ng b
iodi
vers
ity a
nd m
enta
l hea
lth a
nd w
ell-
bein
g (9
stu
dies
iden
tified
fro
m 1
980
to 2
012
(Lov
ell e
t al.
2014
) an
d 16
stu
dies
iden
tified
fro
m 2
013
to S
epte
mbe
r 20
17 in
this
cha
pter
)
Ref
eren
ceO
bjec
tives
Bio
dive
rsity
indi
cato
rC
onta
ct w
ith
natu
rea
Hea
lth o
utco
me
(mea
sure
b )Po
pula
tion
Gen
eral
res
ult
Exp
erim
enta
l stu
dies
Jorg
ense
n et
al.
(201
0)c
Exp
lore
d th
e im
pact
of
com
plex
ity o
f th
e en
viro
nmen
t on
psyc
holo
gica
l re
stor
atio
n
Nat
ural
ness
, bio
dive
rsity
and
st
ruct
ural
com
plex
ity o
f 3
gree
n sp
aces
Indi
rect
, vie
win
g vi
deos
Self
-rep
ort
moo
d (P
rofil
e of
M
ood
Stat
es)
UK
, stu
dent
s fr
om a
si
ngle
uni
vers
ity, 4
7%
fem
ale,
M a
ge =
22
(ran
ge 1
7–40
), n
= 1
02
No
rela
tions
hip
– N
o di
ffer
ence
in m
ood
betw
een
3 gr
een
spac
es.
Wol
f et
al.
(201
7)E
xplo
red
the
impa
ct o
f sp
ecie
s ri
chne
ss o
n m
enta
l hea
lth a
nd
wel
l-be
ing
Stud
y 1:
tree
spe
cies
ri
chne
ss (
high
, low
)In
dire
ct, v
iew
ing
vide
osSe
lf-r
epor
t po
sitiv
e af
fect
(P
AN
AS)
; vi
talit
y (S
ubje
ctiv
e V
italit
y Sc
ale)
; an
d an
xiet
y (S
tate
Tra
it A
nxie
ty
Inve
ntor
y)
Stud
y 1:
USA
, 42%
fe
mal
e, M
age
= 3
6 (r
ange
18
and
over
),
n =
140
Stud
y 1:
Pos
itive
– R
educ
ed
leve
ls o
f an
xiet
y in
hig
h tr
ee
spec
ies
rich
ness
con
ditio
n co
mpa
red
to lo
w c
ondi
tion.
M
argi
nal d
iffe
renc
e be
twee
n co
nditi
ons
on p
ositi
ve a
ffec
t.St
udy
1: N
o re
latio
nshi
p –
No
diff
eren
ce b
etw
een
high
an
d lo
w tr
ee s
peci
es r
ichn
ess
cond
ition
s on
vita
lity.
Stud
y 2:
bir
d sp
ecie
s ri
chne
ss (
high
, low
)St
udy
2: U
SA, 5
2%
fem
ale,
M a
ge =
35
(ran
ge 1
8 an
d ov
er),
n
= 2
64
Stud
y 2:
Pos
itive
–
Enh
ance
d le
vels
of
posi
tive
affe
ct, a
nd r
educ
ed a
nxie
ty
in h
igh
bird
spe
cies
ric
hnes
s co
nditi
on c
ompa
red
to lo
w
cond
ition
.St
udy
2: N
o re
latio
nshi
p –
No
diff
eren
ce b
etw
een
high
an
d lo
w b
ird
spec
ies
rich
ness
co
nditi
ons
on v
italit
y.
Ref
eren
ceO
bjec
tives
Bio
dive
rsity
indi
cato
rC
onta
ct w
ith
natu
rea
Hea
lth o
utco
me
(mea
sure
b )Po
pula
tion
Gen
eral
res
ult
Qua
si-e
xper
imen
tal s
tudi
es
Cra
ckne
ll et
al.
(201
7),
Stud
y 2
only
Exp
lore
d th
e ef
fect
of
biod
iver
sity
of
aqua
rium
ex
hibi
t on
affe
ct
Spec
ies
rich
ness
of
mar
ine
faun
a (h
igh,
low
); a
bund
ance
(h
igh,
low
) of
fish
/cr
usta
cean
s
Indi
rect
, vie
win
g ph
otog
raph
sSe
lf-r
epor
t ha
ppin
ess
UK
, stu
dent
s fr
om a
si
ngle
uni
vers
ity,
67.5
% f
emal
e, M
ag
e =
20.
8 (r
ange
18–
35),
n =
40
Posi
tive
– H
ighe
r le
vels
of
happ
ines
s in
hig
h ab
unda
nce,
com
pare
d to
low
ab
unda
nce
cond
ition
, whe
n sp
ecie
s ri
chne
ss h
eld
cons
tant
.N
o re
latio
nshi
p –
No
diff
eren
ce in
hig
h or
low
sp
ecie
s ri
chne
ss c
ondi
tions
on
hap
pine
ss, w
hen
abun
danc
e is
hel
d co
nsta
nt.
Joha
nsso
n et
al.
(201
4)E
xplo
red
effe
ct o
f di
ffer
ent l
evel
s of
bi
odiv
ersi
ty in
for
est
biot
opes
on
affe
ct
Cat
egor
ised
3 b
road
-lea
f fo
rest
bio
tope
s ba
sed
on
vege
tatio
n la
yer,
spec
ies
com
posi
tion
and
vege
tatio
n ty
pe (
high
, med
ium
, low
)
Indi
rect
, vie
win
g ph
otog
raph
sSe
lf-r
epor
t af
fect
(B
asic
E
mot
iona
l Pr
oces
s)
Swed
en, s
taff
fro
m a
si
ngle
uni
vers
ity a
nd
thei
r fa
mily
and
fr
iend
s, 5
1% f
emal
e,
M a
ge =
46;
n =
35
Posi
tive
– A
ffec
t was
gr
eate
st in
the
med
ium
bi
otop
e, f
ollo
wed
by
the
high
and
then
the
low
bi
otop
es.
Whi
te e
t al.
(201
7),
Stud
y A
onl
y
Exp
lore
d th
e ef
fect
of
perc
eive
d bi
odiv
ersi
ty
on m
enta
l wel
l-be
ing
Perc
eive
d bi
odiv
ersi
ty (
high
, m
ediu
m, l
ow)
Indi
rect
, vie
win
g ph
otog
raph
sSe
lf-r
epor
t m
ood
(val
ence
, Fe
elin
gs S
cale
);
arou
sal (
Felt
Aro
usal
Sca
le),
an
d re
cove
ry
UK
, 51%
fem
ale,
ag
e ra
nge
18–8
0 (n
o m
ean
give
n) n
= 1
,478
Posi
tive
– G
reat
er p
erce
ived
bi
odiv
ersi
ty a
ssoc
iate
d w
ith
incr
ease
in p
ositi
ve v
alen
ce,
arou
sal a
nd r
ecov
ery.
Nat
ural
exp
erim
ent
Cra
ckne
ll et
al.
(201
6),
Stud
y 2
only
Exp
lore
d th
e ef
fect
of
rest
ocki
ng a
n aq
uari
um
with
mar
ine
biot
a on
af
fect
Spec
ies
rich
ness
of
fish/
crus
tace
ans
(low
, hig
h)In
dire
ct, v
iew
ing
natu
re in
an
aqua
rium
Self
-rep
ort
moo
d (v
alen
ce,
Feel
ing
Scal
e;
and
arou
sal
(Fel
t Aro
usal
Sc
ale)
UK
, stu
dent
s fr
om a
si
ngle
uni
vers
ity, 7
6%
fem
ale,
M a
ge =
24,
n
= 8
4
No
rela
tions
hip
– N
o di
ffer
ence
in m
ood
betw
een
low
and
hig
h bi
odiv
ersi
ty
cond
ition
s.
(con
tinue
d)
Tabl
e 9.
1 (c
ontin
ued)
Ref
eren
ceO
bjec
tives
Bio
dive
rsity
indi
cato
rC
onta
ct w
ith
natu
rea
Hea
lth o
utco
me
(mea
sure
b )Po
pula
tion
Gen
eral
res
ult
Jone
s (2
017)
Exp
lore
d th
e im
pact
of
an in
vasi
ve s
peci
es o
n m
enta
l hea
lth a
nd
wel
l-be
ing
Pres
ence
of
the
inva
sive
sp
ecie
s E
mer
ald
ash
bore
r (E
AB
) (A
gril
us p
lani
penn
is),
w
hich
is r
espo
nsib
le f
or th
e lo
ss o
f N
orth
Am
eric
an a
sh
tree
s (F
raxi
nus
spp.
)
Uns
peci
fied,
as
sess
men
ts o
f E
AB
infe
stat
ions
in
US
coun
ties
Self
-rep
ort
depr
essi
on
(sin
gle
item
fr
om P
HQ
-12)
an
d lif
e sa
tisfa
ctio
n
USA
, peo
ple
who
live
in
189
cou
ntie
s w
ith
dete
cted
EA
B
infe
stat
ions
in 1
5 st
ates
, 61%
fem
ale,
M
age
= 5
3, n
= 4
81,4
05
Posi
tive
– B
iodi
vers
ity lo
ss
of a
sh tr
ees,
5-y
ears
aft
er
EA
B d
etec
tion,
ass
ocia
ted
with
less
life
sat
isfa
ctio
n an
d m
ore
depr
essi
ve s
ympt
oms.
Lon
gitu
dina
l (co
hort
) st
udie
s
Ann
erst
edt
et a
l. (2
012)
c
Exp
lore
d th
e im
pact
of
the
pres
ence
of
envi
ronm
enta
l qua
litie
s on
men
tal h
ealth
ove
r a
5-ye
ar p
erio
d
Scan
ia G
reen
Sco
re ‘
lush
, ri
ch in
spe
cies
’: P
erce
ived
en
viro
nmen
tal d
imen
sion
s id
entifi
ed u
sing
CO
RIN
E
land
cov
er d
ata.
Uns
peci
fied,
as
sess
ed d
iver
sity
30
0 m
fro
m
part
icip
ants
’ ho
me
Self
-rep
ort
men
tal h
ealth
(G
HQ
-12)
Swed
en, R
esid
ents
of
rura
l and
sub
urba
n ar
eas
who
did
not
m
ove
hous
e, g
ende
r %
no
t giv
en, M
age
w
omen
= 5
0, n
= 7
,549
No
rela
tions
hip
– N
o ef
fect
of
livi
ng in
an
envi
ronm
ent
that
is ‘
rich
in s
peci
es’
on
men
tal h
ealth
.
Ann
erst
edt
van
den
Bos
ch e
t al.
(201
5)
Exp
lore
d if
cha
nges
in
neig
hbou
rhoo
d na
ture
, as
an
effe
ct o
f m
ovin
g ho
me,
are
rel
ated
to
men
tal h
ealth
Scan
ia G
reen
Sco
re ‘
lush
, ri
ch in
spe
cies
’: P
erce
ived
en
viro
nmen
tal d
imen
sion
s id
entifi
ed u
sing
CO
RIN
E
land
cov
er d
ata.
Uns
peci
fied,
as
sess
ed d
iver
sity
30
0 m
fro
m
part
icip
ants
’ ho
me
Self
-rep
ort
men
tal h
ealth
(G
HQ
-12)
Swed
en, R
esid
ents
of
rura
l and
sub
urba
n ar
eas
who
mov
ed
hous
e, 5
8% f
emal
e, M
ag
e =
48,
n =
1,4
19
No
rela
tions
hip
– M
ovin
g to
an
env
iron
men
t tha
t is
mor
e ‘r
ich
in s
peci
es’
had
no
effe
ct o
n m
enta
l hea
lth.
Rep
eate
d m
easu
res
stud
ies
Mar
selle
et
al.
(201
6)E
xplo
red
indi
rect
eff
ect
of p
erce
ived
bio
dive
rsity
on
aff
ect t
hrou
gh
perc
eive
d re
stor
ativ
enes
s
Perc
eive
d sp
ecie
s ri
chne
ss
of: p
lant
s/tr
ees;
bir
ds; a
nd
butte
rflie
s
Dir
ect,
wal
ks
outd
oors
Self
-rep
ort
affe
ct (
PAN
AS)
an
d ha
ppin
ess
UK
, Eng
lish
resi
dent
s w
ho p
artic
ipat
e in
gr
oup
wal
ks, 5
5%
fem
ale,
age
ran
ge
55 a
nd o
ver
(no
mea
n gi
ven)
, n =
127
Posi
tive
– Pe
rcei
ved
bird
bi
odiv
ersi
ty in
dire
ctly
in
fluen
ces
affe
ct a
nd
happ
ines
s vi
a pe
rcei
ved
rest
orat
iven
ess.
No
rela
tions
hip
– N
o in
dire
ct e
ffec
t of
perc
eive
d pl
ants
/tree
s an
d bu
tterfl
ies
spec
ies
rich
ness
on
affe
ct o
r ha
ppin
ess
via
perc
eive
d re
stor
ativ
enes
s.
Ref
eren
ceO
bjec
tives
Bio
dive
rsity
indi
cato
rC
onta
ct w
ith
natu
rea
Hea
lth o
utco
me
(mea
sure
b )Po
pula
tion
Gen
eral
res
ult
Mar
selle
et
al.
(201
5)E
xplo
red
the
dire
ct
effe
ct o
f pe
rcei
ved
biod
iver
sity
on
affe
ct
Perc
eive
d sp
ecie
s ri
chne
ss
of: p
lant
s/tr
ees;
bir
ds; a
nd
butte
rflie
s
Dir
ect,
wal
ks
outd
oors
Self
-rep
ort
affe
ct (
PAN
AS)
an
d ha
ppin
ess
UK
, Eng
lish
resi
dent
s w
ho p
artic
ipat
e in
gr
oup
wal
ks, 5
5%
fem
ale,
age
ran
ge
55 a
nd o
ver
(no
mea
n gi
ven)
, n =
127
No
rela
tions
hip
– N
o as
soci
atio
n of
per
ceiv
ed
biod
iver
sity
on
posi
tive
affe
ct o
r ha
ppin
ess.
Neg
ativ
e –
Smal
l inc
reas
e in
pe
rcei
ved
bird
spe
cies
ri
chne
ss w
as r
elat
ed to
mor
e ne
gativ
e em
otio
ns.
Cro
ss-s
ecti
onal
stu
dies
Bjo
rk e
t al.
(200
8)c
Exp
lore
d th
e im
pact
of
the
pres
ence
of
pref
erre
d en
viro
nmen
tal
dim
ensi
ons
in p
rom
otin
g he
alth
and
wel
l-be
ing
Scan
ia G
reen
Sco
re ‘
lush
, ri
ch in
spe
cies
’: P
erce
ived
en
viro
nmen
tal d
imen
sion
s id
entifi
ed u
sing
CO
RIN
E
land
cov
er d
ata.
Uns
peci
fied,
as
sess
ed d
iver
sity
10
0 an
d 30
0 m
fr
om p
artic
ipan
ts’
hom
e
Self
-rep
ort
phys
ical
and
ps
ycho
logi
cal
heal
th; a
nd
vita
lity
(SF3
6)
Swed
en, R
esid
ents
of
rura
l and
sub
urba
n ar
eas,
54%
fem
ale,
M
age
50 (
rang
e 19
–76)
, n
= 2
4,81
9
No
rela
tions
hip
– N
o ef
fect
of
livi
ng n
ear
to a
‘lu
sh, r
ich
in s
peci
es’
envi
ronm
ent o
n he
alth
or
vita
lity.
Car
rus
et a
l. (2
015)
Exp
lore
d th
e di
rect
ef
fect
of
leve
l of
biod
iver
sity
on
phys
ical
an
d m
enta
l wel
l-be
ing,
an
d in
dire
ct e
ffec
t th
roug
h pe
rcei
ved
rest
orat
iven
ess
Cat
egor
ised
4 g
reen
spa
ces
base
d on
str
uctu
ral
com
plex
ity (
low
, hig
h)
Dir
ect,
in-s
itu
asse
ssm
ents
of
4 gr
een
spac
es
Self
-rep
ort
phys
ical
and
m
enta
l w
ell-
bein
g (c
ompo
site
m
easu
re)
Ital
y, u
sers
of
gree
n sp
ace,
52%
fem
ale,
M
age
= 4
1, n
= 5
68
Posi
tive
– G
reat
er p
hysi
cal
and
men
tal w
ell-
bein
g in
hi
gh b
iodi
vers
ity c
ondi
tion,
co
mpa
red
to lo
w c
ondi
tion.
Posi
tive
– In
dire
ct e
ffec
t of
biod
iver
sity
on
phys
ical
and
m
enta
l wel
l-be
ing
via
perc
eive
d re
stor
ativ
enes
s.C
ox e
t al.
(201
7)E
xplo
red
the
asso
ciat
ion
betw
een
neig
hbou
rhoo
d na
ture
and
men
tal h
ealth
Bir
d ab
unda
nce
in th
e m
orni
ng a
nd a
fter
noon
; bir
d sp
ecie
s ri
chne
ss in
the
mor
ning
and
aft
erno
on.
Uns
peci
fied,
bi
odiv
ersi
ty
asse
ssed
250
m
from
cen
tre
of
part
icip
ants
’ po
stco
de
Self
-rep
ort
men
tal h
ealth
(D
epre
ssio
n;
Anx
iety
; Str
ess,
D
ASS
21)
.
UK
, res
iden
ts in
3
tow
ns in
sou
ther
n E
ngla
nd, 5
6% f
emal
e,
age
rang
e 18
and
ove
r (n
o m
ean
give
n),
n =
263
Posi
tive
– G
reat
er a
fter
noon
bi
rd a
bund
ance
ass
ocia
ted
with
less
dep
ress
ion,
anx
iety
an
d st
ress
.N
o re
latio
nshi
p –
No
effe
ct
of m
orni
ng b
ird
abun
danc
e,
and
mor
ning
and
aft
erno
on
bird
spe
cies
ric
hnes
s on
m
enta
l hea
lth.
(con
tinue
d)
Tabl
e 9.
1 (c
ontin
ued)
Ref
eren
ceO
bjec
tives
Bio
dive
rsity
indi
cato
rC
onta
ct w
ith
natu
rea
Hea
lth o
utco
me
(mea
sure
b )Po
pula
tion
Gen
eral
res
ult
Dal
limer
et
al.
(201
2)c
Exp
lore
d th
e ro
le o
f sp
ecie
s ri
chne
ss in
ri
veri
ne e
nvir
onm
ents
in
prom
otin
g ps
ycho
logi
cal
wel
l-be
ing
Spec
ies
rich
ness
of:
bir
ds;
butte
rflie
s; a
nd p
lant
/tree
s;
bird
abu
ndan
ce; S
hann
on
Div
ersi
ty I
ndex
of
habi
tat
type
s; tr
ee c
over
; per
ceiv
ed
spec
ies
rich
ness
of:
bir
ds,
butte
rflie
s an
d pl
ant/t
rees
Dir
ect,
in-s
itu
asse
ssm
ents
of
34
gree
n sp
aces
Self
-rep
ort
psyc
holo
gica
l w
ell-
bein
g (r
eflec
tion;
co
ntin
uity
with
th
e pa
st; a
nd
atta
chm
ent
subs
cale
s)
UK
, use
rs o
f gr
een
spac
e, 3
8% f
emal
e,
age
rang
e 16
–70
(no
mea
n gi
ven)
, n =
1,1
08
Posi
tive
– G
reat
er b
ird
abun
danc
e an
d bi
rd s
peci
es
rich
ness
, tre
e co
ver,
and
perc
eive
d sp
ecie
s ri
chne
ss o
f bi
rds,
but
terfl
ies
and
plan
ts/
tree
s po
sitiv
ely
asso
ciat
ed
with
psy
chol
ogic
al
wel
l-be
ing.
Neg
ativ
e –
Psyc
holo
gica
l w
ell-
bein
g de
clin
ed w
ith
grea
ter
plan
t spe
cies
ri
chne
ss.
No
rela
tions
hip
– B
utte
rfly
biod
iver
sity
and
Sha
nnon
D
iver
sity
Ind
ex h
ad n
o ef
fect
on
psyc
holo
gica
l wel
l- be
ing.
De
Jong
et
al.
(201
2)c
Exp
lore
d as
soci
atio
ns
betw
een
envi
ronm
enta
l di
men
sion
s an
d ge
nera
l he
alth
Scan
ia G
reen
Sco
re ‘
lush
, ri
ch in
spe
cies
’: P
erce
ived
en
viro
nmen
tal d
imen
sion
s.
CO
RIN
E la
nd c
over
dat
a.
Uns
peci
fied,
as
sess
ed d
iver
sity
30
0 m
fro
m
part
icip
ants
’ ho
me
Self
-rep
ort
gene
ral h
ealth
(p
hysi
cal a
nd
men
tal h
ealth
)
Swed
en, R
esid
ents
of
rura
l and
sub
urba
n ar
eas,
55%
fem
ale,
ag
e ra
nge
18–8
0 (n
o m
ean
give
n),
n =
24,
847
No
rela
tions
hip
– N
o ef
fect
of
livi
ng n
ear
to a
‘lu
sh, r
ich
in s
peci
es’
envi
ronm
ent o
n he
alth
, aft
er a
djus
ting
for
cova
riat
es.
Dua
rte-
Ta
gles
et a
l. (2
015)
Exp
lore
d th
e as
soci
atio
n be
twee
n bi
odiv
ersi
ty
indi
cato
rs a
nd
prev
alen
ce o
f de
pres
sive
sy
mpt
oms
Mar
gale
f D
iver
sity
inde
x of
ec
o-re
gion
sU
nspe
cifie
d,
biod
iver
sity
as
sess
ed a
t sta
te
leve
l
Self
-rep
ort
men
tal h
ealth
(b
ased
on
DSM
-IV
cri
teri
a fo
r de
pres
sion
)
Mex
ico,
res
iden
ts in
all
stat
es, 7
8.7%
fem
ale,
M
age
40.
5 (r
ange
20–
65),
n
= 4
,777
No
rela
tions
hip
– M
ore
ecor
egio
ns in
the
stat
e lo
wer
s th
e ri
sk o
f de
pres
sion
. How
ever
, no
effe
ct w
hen
acco
untin
g fo
r hi
erar
chic
al q
ualit
y of
dat
a.
Ref
eren
ceO
bjec
tives
Bio
dive
rsity
indi
cato
rC
onta
ct w
ith
natu
rea
Hea
lth o
utco
me
(mea
sure
b )Po
pula
tion
Gen
eral
res
ult
Foo
(201
6)E
xplo
red
the
med
iatin
g pa
thw
ays
betw
een
envi
ronm
ent w
ith
diff
eren
t lev
els
of
natu
raln
ess
and
wel
l-be
ing
Thr
ee f
ores
ts th
at v
ary
on
thei
r sp
ecie
s ri
chne
ss (
low
, m
ediu
m, h
igh)
Dir
ect,
in s
itu
asse
ssm
ents
of
3 fo
rest
env
iron
men
ts
Self
-rep
ort
wel
l-be
ing;
and
m
enta
l hea
lth
Mal
aysi
a, U
sers
of
gree
n sp
ace.
No
gend
er
or a
ge g
iven
, n =
350
No
rela
tions
hip
– A
ll th
ree
leve
ls o
f fo
rest
div
ersi
ty h
ad
a si
mila
r in
fluen
ce o
n w
ell-
bein
g an
d m
enta
l he
alth
, but
med
iatin
g pa
thw
ays
diff
ered
.Fu
ller
et a
l. (2
007)
c
Exp
lore
d th
e ef
fect
of
spec
ies
rich
ness
in u
rban
gr
een
spac
e to
ps
ycho
logi
cal
wel
l-be
ing
Spec
ies
rich
ness
of:
bir
ds;
butte
rflie
s; a
nd p
lant
s;
num
ber
of h
abita
t typ
es; a
nd
tree
cov
er
Dir
ect,
in-s
itu
asse
ssm
ents
of
15
gree
n sp
aces
Self
-rep
ort
psyc
holo
gica
l w
ell-
bein
g (r
eflec
tion;
di
stin
ct id
entit
y;
cont
inui
ty w
ith
the
past
; and
at
tach
men
t su
bsca
les)
UK
, use
rs o
f gr
een
spac
e, n
o ge
nder
or
age
give
n, n
= 3
12
Posi
tive
– G
reat
er b
ird
and
plan
t spe
cies
ric
hnes
s, a
nd
num
ber
of h
abita
t typ
es
posi
tivel
y as
soci
ated
with
ps
ycho
logi
cal w
ell-
bein
g.N
o re
latio
nshi
p –
But
terfl
y sp
ecie
s ri
chne
ss a
nd tr
ee
cove
r w
ere
not a
ssoc
iate
d w
ith p
sych
olog
ical
w
ell-
bein
g.G
rahn
&
Stig
sdot
ter
(201
0)c
Atte
mpt
ed to
iden
tify
the
dim
ensi
ons
of n
atur
e pe
ople
pre
fer
and
use
for
stre
ss r
elie
f
Perc
eive
d en
viro
nmen
tal
dim
ensi
ons:
‘ri
ch in
spe
cies
’ (p
recu
rsor
to S
cani
a gr
een
scor
e)
Not
app
licab
le
Self
-rep
ort l
evel
of
str
ess
Swed
en, r
esid
ents
in
cent
ral a
nd s
outh
ern
urba
n ar
eas,
no
gend
er
or a
ge g
iven
, n =
733
No
rela
tions
hip
– E
nvir
onm
ents
‘ri
ch in
sp
ecie
s’ n
ot s
igni
fican
tly
corr
elat
ed w
ith s
tres
s le
vel.
Hub
y et
al.
(200
6)c
Exp
lore
d th
e in
tegr
atio
n of
nat
ural
and
soc
ial
scie
nces
dat
a to
un
ders
tand
rel
atio
nshi
ps
betw
een
envi
ronm
ent
and
soci
ety
Bir
d sp
ecie
s ri
chne
ssU
nspe
cifie
d, L
ower
Su
per
Out
put
Are
as (
LSO
A)
Men
tal h
ealth
de
priv
atio
n in
dica
tor
of
Eng
lish
Indi
ces
of D
epri
vatio
n
Eng
land
, res
iden
ts o
f ru
ral a
reas
, no
gend
er,
age
or n
giv
en
Posi
tive
– G
reat
er b
ird
spec
ies
rich
ness
ass
ocia
ted
with
men
tal h
ealth
. (con
tinue
d)
Tabl
e 9.
1 (c
ontin
ued)
Ref
eren
ceO
bjec
tives
Bio
dive
rsity
indi
cato
rC
onta
ct w
ith
natu
rea
Hea
lth o
utco
me
(mea
sure
b )Po
pula
tion
Gen
eral
res
ult
Luc
k et
al.
(201
1)c
Exa
min
ed th
e re
latio
nshi
ps b
etw
een
biod
iver
sity
and
re
side
nts’
per
sona
l w
ell-
bein
g,
neig
hbou
rhoo
d w
ell-
bein
g, a
nd
conn
ectio
n to
nat
ure
Bir
d sp
ecie
s ri
chne
ss;
abun
danc
e of
bir
ds; a
mou
nt
of v
eget
atio
n co
ver;
and
ve
geta
tion
dens
ity
Uns
peci
fied,
as
sess
ed d
iver
sity
in
the
neig
hbou
rhoo
d
Self
-rep
ort l
ife
satis
fact
ion
Aus
tral
ia, r
esid
ents
of
New
Sou
th W
ales
and
V
icto
ria,
no
gend
er o
r ag
e gi
ven,
n =
1,0
78
Posi
tive
– L
ife
satis
fact
ion
posi
tivel
y as
soci
ated
with
gr
eate
r bi
rd s
peci
es r
ichn
ess
and
abun
danc
e an
d ve
geta
tion
cove
r an
d de
nsity
.
Ran
tako
kko
et a
l. (2
018)
Exp
lore
d th
e as
soci
atio
n be
twee
n ne
ighb
ourh
ood
natu
re d
iver
sity
and
m
enta
l hea
lth a
nd
wel
l-be
ing
Shan
non
Div
ersi
ty I
ndex
of
land
use
type
sU
nspe
cifie
d,
asse
ssed
div
ersi
ty
500
m f
rom
pa
rtic
ipan
ts’
hom
e.
Self
-rep
ort
men
tal
wel
l-be
ing
(WH
O Q
oL)
and
men
tal
heal
th
(dep
ress
ion,
C
ES-
D)
Cen
tral
Fin
land
, old
er
peop
le, 6
2% f
emal
e, M
ag
e =
80.
6 (r
ange
75–
90),
n =
848
Posi
tive
– G
reat
er S
hann
on
Div
ersi
ty o
f la
nd u
se
type
s as
soci
ated
with
gre
ater
qu
ality
of
life.
No
rela
tions
hip
– N
o ef
fect
of
Sha
nnon
Div
ersi
ty o
f la
nd
use
type
s on
dep
ress
ive
sym
ptom
s.Sa
w e
t al.
(201
5)E
xplo
red
the
effe
ct o
f ac
cess
to d
iffe
rent
type
s of
gre
en s
pace
on
wel
l-be
ing
Nat
ure
rese
rves
(le
gally
pr
otec
ted
site
s fo
r w
ildlif
e,
flora
and
fau
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re r
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e un
iver
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, 68%
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mal
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–35
(no
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tions
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dive
rsity
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cato
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ct w
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lth o
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eler
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al.
(201
5)E
xplo
red
the
asso
ciat
ion
betw
een
type
and
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lity
of d
iffe
rent
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ural
en
viro
nmen
ts a
nd h
ealth
Shan
non
Div
ersi
ty I
ndex
of
land
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er ty
pes;
and
bir
d sp
ecie
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chne
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peci
fied,
bi
odiv
ersi
ty
asse
ssed
at L
ower
Su
per
Out
put A
reas
(L
SOA
)
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-rep
orte
d ge
nera
l hea
lthU
K, R
esid
ents
of
Eng
land
agg
rega
ted
at
LSO
A, n
o ge
nder
, age
or
n g
iven
Posi
tive
– G
reat
er S
hann
on
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ersi
ty o
f la
nd c
over
as
soci
ated
with
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d he
alth
, an
d in
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atio
ns w
ith
bad
heal
th. B
ird
spec
ies
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ness
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itive
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ocia
tion
with
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d he
alth
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e. B
iodi
vers
ity v
aria
bles
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a s
lash
(‘/
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bine
d va
riab
le w
here
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stig
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trib
utio
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h ta
xon;
two
taxa
are
ana
-ly
sed
toge
ther
a ‘D
irec
t’ a
nd ‘
indi
rect
’ co
ntac
t with
nat
ure
cate
gori
es b
ased
on
Ken
iger
et a
l. (2
013)
b Mea
sure
s ar
e lis
ted
only
whe
n re
port
ed b
y th
e or
igin
al a
utho
rsc S
tudy
fro
m L
ovel
l et a
l. (2
014)
188
Contact with the biodiverse environment was coded as either indirect or direct following Keniger et al. (2013). Indirect contact “does not require a person to be physically present in nature” (Keniger et al. 2013, p. 916) and can include viewing nature through a window, and looking at photographs, paintings or motion pictures of nature. Direct contact with nature stipulates that nature, or natural elements, are physically present in the same space as the individual (Keniger et al. 2013).1 Examples of direct contact include indoor plants, using urban green spaces for edu-cation purposes, reading or having a picnic in the park, doing sports or exercise in a natural setting, gardening and camping.
Moderating variables were categorised as either personal (e.g. age, gender, socio- economic status) or contextual (e.g. urbanicity, safety) (Hartig et al. 2014; Markevych et al. 2017). Mediators were classified as ‘reducing harm’, ‘restoring capacities’ or ‘building capacities’ according to Markevych et al. (2017). ‘Reducing harm’ consid-ers the role of the natural environment to reduce exposure to environmental stressors like heat or noise pollution. ‘Restoring capacities’ mediators support renewal of adapted resources that have become depleted through everyday demands, such as attention restoration and stress recovery. ‘Building capacities’ mediators highlight the role of green spaces in strengthening an individual’s capacity to acquire new adaptive resources like fostering physical activity and social cohesion.
9.2.3 Synthesis of Results
To provide a synthesis of results assessing the influence of biodiversity on mental health and well-being, a combined set of 24 studies, drawn from Lovell et al. (2014) and from our updated review, was utilised. Nine quantitative studies identified in Lovell et al. (2014) that assessed biodiversity and mental health and well-being relationships were included (Table 9.1). Consequently, 4 studies from Lovell et al. (2014) with physical health as the outcome were excluded (Huynen et al. 2004; Poudyal et al. 2009; Sieswerda et al. 2001; Tilt et al. 2007). Also excluded were 4 studies that, according to Lovell et al. (2014), did not directly assess biodiversity but were included in their analysis nevertheless (Barton et al. 2009; Curtin 2009; Lemieux et al. 2012; Pereira et al. 2005). In this sense our synthesis of results is more critical than Lovell et al.’s (2014) by including only those studies that consider the biodiversity of the environment in some way. Fifteen of the 16 articles identified in our updated search were included in the synthesis of results. Foo (2016) was excluded from the synthesis of results because it analysed the associations between use of the environment, individual differences in environmental experience, and perceived physical activity, well-being and mental health given a certain level of actual biodiversity instead of an investigation of the influence of biodiversity levels on mental health and well-being.
1 This is a combination of Keniger et al. (2013) ‘incidental’ and ‘intentional’ interaction types as both describe being in the presence of nature.
M. R. Marselle et al.
189
Due to the heterogeneity of the selected articles in terms of research design, measures and participants, data were analysed using narrative synthesis (Popay et al. 2006). The purpose of narrative synthesis is to identify the factors that explain the differences in results in the body of literature (Popay et al. 2006). Patterns of results across all 24 studies were identified according to study design, measures of biodiversity and mental health or well-being. Vote counting (Popay et al. 2006) was used to describe the frequency of significant and non-significant results across the 24 quantitative studies. This analytical approach has been used previously (Lovell et al. 2014). While we acknowledge that vote counting has known deficiencies (e.g. giving equal weight to studies with different research designs, samples and effect sizes), it is a useful as a preliminary interpretation of results across studies (Popay et al. 2006). Our findings should thus be interpreted with caution.
9.3 Results
9.3.1 Characteristics of the Recent Literature, Published Since Lovell et al.’s (2014) Review, Relating Biodiversity to Mental Health and Well-being
The following describes the recent literature (n = 16), published since 2012, on biodiversity and mental health and well-being. See Lovell et al. (2014) for descrip-tion of the body of evidence up to 2012.
All 16 studies examined, wholly or in part, the relationships between biodiver-sity and one or more mental health or well-being outcomes (see Table 9.1). Eleven studies were based in Western Europe, three in North America and two in Asia. Two studies were from emerging economies of Malaysia and Mexico. Six different study designs were used to examine the relationship between biodiversity and mental health and well-being (Fig. 9.2).
9.3.1.1 Spatial Scale
The spatial scale at which the relationships were examined ranged from the national (Duarte-Tagles et al. 2015; Wheeler et al. 2015) to the local (Carrus et al. 2015; Foo 2016; Marselle et al. 2015, 2016). Specifically, scales considered whole countries (England (Wheeler et al. 2015) and Mexico (Duarte-Tagles et al. 2015)), geographi-cal regions within countries (England (Cox et al. 2017), Finland (Rantakokko et al. 2018), Sweden (Annerstedt van den Bosch et al. 2015), the USA (Jones 2017)) and specific places such as forests in the Klang Valley region of Malaysia (Foo 2016), protected nature reserves in Singapore (Saw et al. 2015) and green spaces in Italy (Carrus et al. 2015).
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9.3.1.2 Participants
The number of participants varied considerably among the recently published stud-ies: ranging from 35 (Johansson et al. 2014) through to the millions (with the use of data from the national census, Wheeler et al. 2015). Participant type also differed, including university students (Cracknell et al. 2016, 2017; Saw et al. 2015) and staff (Johansson et al. 2014), adults participating over the internet (White et al. 2017; Wolf et al. 2017), group walkers over the age of 55 (Marselle et al. 2015; Marselle et al. 2016), park users (Carrus et al. 2015), visitors to forests (Foo 2016), and resi-dents of specific countries or regions as previously detailed (Annerstedt van den Bosch 2015; Cox et al. 2017; Duarte-Tagles et al. 2015; Jones 2017; Rantakokko et al. 2018; Wheeler et al. 2015).
9.3.1.3 Theoretical Position
Where articulated, the theoretical underpinnings largely reflected the dominant understandings of environment-health linkages (for further discussion on biodiver-sity and health theories, see Marselle Chap. 7, this volume). Specifically, 9 studies (Annerstedt van den Bosch, et al. 2015; Cox et al. 2017; Cracknell et al. 2016, 2017; Foo 2016; Marselle et al. 2015, 2016; Saw et al. 2015; White et al. 2017) used the Attention Restoration Theory (Kaplan and Kaplan 1989; Kaplan 1995) and the Stress Reduction Theory (Ulrich 1983; Ulrich et al. 1991) to explain the effects of biodiversity on mental health and/or well-being. Additionally, the Biophilia hypoth-esis (Kellert and Wilson 1993) was also mentioned (Annerstedt van den Bosch et al.
Experimental
Quasi-experimental
Natural experiment
Longitudinal (cohort)
Repeated measures
Cross-sectional
0 2 4Number of studies
Typ
e o
f st
ud
y d
esig
n
6 8
Fig. 9.2 Type of study design used to examine biodiversity and mental health and well-being relationships across the 16 studies published after 2012
M. R. Marselle et al.
191
2015; Carrus et al. 2015; Saw et al. 2015; Wolf et al. 2017), as was appraisal theory (Johansson et al. 2014). Four studies (Duarte-Tagles et al. 2015; Jones 2017; Rantakokko et al. 2018; Wheeler et al. 2015) did not articulate a theory for why or how biodiversity may be related to better health and well-being.
9.3.1.4 Biodiversity Assessment
There was considerable variation across the 16 studies on the organisational level at which biodiversity was studied, the data collection method used, and the type of environment/organism investigated (see Table 9.2). Seven studies assessed biodi-versity at the ecosystem or habitat level. Measurement across these studies included use of secondary, geographically-referenced data to determine land cover and land use diversity using the Shannon Diversity Index (Rantakokko et al. 2018; Wheeler et al. 2015), eco-region diversity using the Margalef Diversity Index (Duarte-Tagles et al. 2015) and access to protected areas (Saw et al. 2015). Investigator categorisa-tion of ecosystem/habitat biodiversity was used to classify environments into low, medium and high biodiversity biotopes (Johansson et al. 2014) or low vs. high bio-diverse green spaces (Carrus et al. 2015). Participants’ perception of habitats/eco-system was used in one study; the Scania Green Score uses interpreted satellite imagery-derived land use data (i.e. mixed forest and marshes, beaches, sand plains and bare rock, biotopes and national parks) to map perceived biodiversity (‘lush, rich in species’) of an environment (Annerstedt van den Bosch et al. 2015). At the species community level, 6 studies assessed biodiversity in terms of species rich-ness for various taxa (i.e. birds, butterflies, plants, trees, fish/crustaceans). Species richness was measured using standard ecological field survey techniques (Cox et al. 2017; Cracknell et al. 2016), secondary data (Wheeler et al. 2015) or investigator categorisation of species richness (e.g. low vs. high based on assessment of content in images or videos (Cracknell et al. 2017; Wolf et al. 2017)). Participants’ percep-tion of species richness was employed in 3 studies (Marselle et al. 2015, 2016; White et al. 2017). At the species community level, abundance of a specific taxo-nomic group (i.e. birds, fish/crustaceans) was also assessed in 2 studies using stan-dard ecological survey techniques (Cox et al. 2017), and investigator categorisation of stimuli (i.e. low vs. high abundance; Cracknell et al. 2017). At the single species level, Jones (2017) investigated biodiversity loss and ecosystem health through the loss of North American ash trees (Fraxinus spp.) following the presence of the inva-sive species emerald ash borer (EAB) (Agrilus planipennis). This was assessed using secondary data.
9.3.1.5 Mental Health and Well-being Assessment
There was considerable variation in the outcomes considered and the measures used among the studies (Fig. 9.3). Mental health was assessed in 7 studies (Annerstedt van den Bosch et al. 2015; Cox et al. 2017; Duarte-Tagles et al. 2015; Foo 2016;
9 Review of the Mental Health and Well-being Benefits of Biodiversity
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Tabl
e 9.
2 L
evel
of
biod
iver
sity
inve
stig
ated
and
dat
a co
llect
ion
met
hod
used
in th
e 16
stu
dies
pub
lishe
d af
ter
2012
Dat
a co
llect
ion
met
hod
Bio
dive
rsity
leve
lSt
anda
rd e
colo
gica
l su
rvey
Seco
ndar
y da
taIn
vest
igat
or c
ateg
oris
atio
n of
bi
odiv
ersi
tyPe
rcei
ved
biod
iver
sity
Eco
syst
ems/
habi
tats
Mar
gale
f D
iver
sity
Ind
ex o
f ec
o-re
gion
s (D
uart
e-Ta
gles
et a
l. 20
15)
Fore
st b
ioto
pes
(Joh
anss
on
et a
l. 20
14)
Scan
ia G
reen
Sco
re
(Ann
erst
edt v
an d
en B
osch
et
al.
2015
)aPr
otec
ted
area
des
igna
tion
(Saw
et
al.
2015
)G
reen
spa
ces
(Car
rus
et a
l. 20
15)
Shan
non
Div
ersi
ty I
ndex
of
land
cov
er
(Whe
eler
et a
l. 20
15)
and
land
use
(R
anta
kokk
o et
al.
2018
)Sp
ecie
s co
mm
unit
ies
Spec
ies
rich
ness
Bir
ds in
the
mor
ning
, and
bi
rds
in th
e af
tern
oon
(Cox
et a
l. 20
17)
Bir
ds (
Whe
eler
et a
l. 20
15)
Fish
/cru
stac
eans
(C
rack
nell
et a
l. 20
17)
Ani
mal
s/pl
ants
(W
hite
et a
l. 20
17)
Plan
ts, b
irds
, mam
mal
s an
d re
ptile
s/am
phib
ians
(Fo
o 20
16)
Bir
ds, b
utte
rflie
s an
d pl
ants
/tr
ees
(Mar
selle
et a
l. 20
16;
Mar
selle
et a
l. 20
15)
Fish
/cru
stac
eans
(Cra
ckne
ll et
al.
2016
)T
rees
and
bir
ds (
Wol
f et
al.
2017
)A
bund
ance
of
a
spec
ific
ta
xono
mic
gro
up
Bir
ds in
the
mor
ning
, and
bi
rds
in th
e af
tern
oon
(Cox
et a
l. 20
17)
Fish
/cru
stac
eans
(C
rack
nell
et a
l. 20
17)
Sing
le s
peci
es
Em
eral
d as
h bo
rer
(EA
B)
(Agr
ilus
pl
anip
enni
s), w
hich
is r
espo
nsib
le f
or
biod
iver
sity
loss
of
Nor
th A
mer
ican
ash
tr
ees
(Fra
xinu
s sp
p.)
(Jon
es 2
017)
Not
e. B
iodi
vers
ity le
vels
are
bas
ed o
n B
otza
t et a
l. (2
016)
. Dat
a in
the
cells
iden
tifies
the
spec
ific
biod
iver
sity
var
iabl
e as
sess
ed; n
o da
ta in
a c
ell m
eans
no
stud
-ie
s in
vest
igat
ed th
at b
iodi
vers
ity le
vel u
sing
a s
peci
fic d
ata
colle
ctio
n m
etho
d. B
iodi
vers
ity v
aria
bles
with
a s
lash
(‘/
’) a
re a
com
bine
d va
riab
le w
here
the
inve
s-tig
ator
did
not
sep
arat
e ou
t the
con
trib
utio
n of
eac
h ta
xon;
two
taxa
are
ana
lyse
d to
geth
era ‘
Lus
h, r
ich
in s
peci
es’
is a
per
ceiv
ed b
iodi
vers
ity a
sses
smen
t tha
t is
then
map
ped
usin
g in
terp
rete
d, s
econ
dary
land
cov
er d
ata
M. R. Marselle et al.
193
Jones 2017; Rantakokko et al. 2018; Wolf et al. 2017). The majority of these assessed depression (Cox et al. 2017; Duarte-Tagles et al. 2015; Jones 2017; Rantakokko et al. 2018) using self-report standardised measures such as the DASS (Cox et al. 2017), CES-D (Rantakokko et al. 2018) and PHQ-12 (Jones 2017). Anxiety was assessed also through the use of standardised self-report measures: DASS (Cox et al. 2017) and the STAI (Wolf et al. 2017). The DASS was addition-ally used to assess perceived stress (Cox et al. 2017). General mental health was assessed by Foo (2016) who utilised scales specifically developed for the study.
Mental well-being was examined in 13 studies (Carrus et al. 2015; Cracknell et al. 2016, 2017; Foo 2016; Johansson et al. 2014; Jones 2017; Marselle et al. 2015, 2016; Rantakokko et al. 2018; Saw et al. 2015; Wheeler et al. 2015; White et al. 2017; Wolf et al. 2017). The majority assessed emotions (Cracknell et al. 2016, 2017; Johansson et al. 2014; Jones 2017; Marselle et al. 2015, 2016; White et al. 2017; Wolf et al. 2017) using standardised self-report measures such as the PANAS (Marselle et al. 2015, 2016; Wolf et al. 2017), the Feeling Scale and Felt Arousal Scale (Cracknell et al. 2016; White et al. 2017), and the Basic Emotional Process 12 (Johansson et al. 2014). Quality of life was assessed with the WHO QoL (Rantakokko et al. 2018). Four studies measured general well-being: 3 studies (Carrus et al. 2015; Foo 2016; Wheeler et al. 2015) did not separate physical from mental well-being, and 1 study (Saw et al. 2015) did not separate mood (a short-term, affective aspect of well-being) from life satisfaction (a long-term, cognitive aspect of well-being, Diener et al. 1985).
Depression
Anxiety
Stress
General mental health
Emotions
Quality of life
General mentalwellbeing
0 2 4
Number of studies
6 8 10
Ind
icat
or
of
men
tal h
ealt
h a
nd
wel
lbei
ng
Fig. 9.3 Number of mental health and mental well-being variables used across the 16 studies published after 2012. The sum may exceed 100% because some studies address more than one mental health or well-being variable
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9.3.1.6 Type of Contact with the Biodiverse Environment
Table 9.3 details the type of contact by biodiversity level. In general, authors hypoth-esised that direct or indirect contact with high biodiverse environments would have a positive effect on mental health and well-being. However, the majority of studies investigated the amount of biodiversity near to the home without specifying the type of contact (Annerstedt van den Bosch et al. 2015; Cox et al. 2017; Duarte-Tagles et al. 2015; Jones 2017; Rantakokko et al. 2018; Saw et al. 2015; Wheeler et al. 2015). Five studies, all experimental, considered indirect contact with biodiversity (Cracknell et al. 2016, 2017; Johansson et al. 2014; White et al. 2017; Wolf et al. 2017). In these studies, participants experienced biodiversity indirectly by viewing photographs (Cracknell et al. 2017; Johansson et al. 2014; White et al. 2017), videos (Wolf et al. 2017) or an aquarium exhibit (Cracknell et al. 2016). Four studies con-sidered direct contact with biodiversity by assessing users who were in specific environments (Carrus et al. 2015; Foo 2016; Marselle et al. 2015, 2016). The impacts of changes in biodiversity on mental health and well-being were investi-gated in 2 studies. Annerstedt van den Bosch et al. (2015) assessed the relationship between mental health and moving to a neighbourhood that is perceived to be ‘lush, rich in species’. Jones (2017) examined the mental health and well-being impact of biodiversity loss of North American ash trees due to the invasive species EAB. None of the studies investigated dose-response relationships of the effect of biodiversity on mental health or well-being.
9.3.1.7 Moderation Analyses
Moderation analyses were conducted in 4 studies (Carrus et al. 2015; Jones 2017; Wheeler et al. 2015; White et al. 2017). These were categorised as either personal (e.g. gender, age, socio-economic status) or contextual (e.g. urbanicity), based on previous research (Hartig et al. 2014; Markevych et al. 2017). Gender was found to moderate the influence of perceived biodiversity on positive affect and recovery; men reported greater positive affect and recovery from high (perceived) species rich environments (White et al. 2017). Age moderated the effect of perceived species richness on arousal (White et al. 2017), and biodiversity loss on life satisfaction (Jones 2017). People less than 35 years old reported more arousal from a perceived species rich environment, than those aged 35 and over (White et al. 2017). Whilst all age groups reported a reduction in life satisfaction from living in EAB infected areas, the largest (and only statistically significant) impact was for young adults aged 18–24 years old (Jones 2017). Socio-economic status was found to moderate the effect of biodiversity on health; the associations of Shannon Diversity of land cover types and bird species richness on health were the strongest for individuals who lived in the most socio-economically deprived neighbourhoods (Wheeler et al. 2015). Other personal variables such as being a member of an environmental organ-isation (White et al. 2017) had no moderating effect. The biodiversity-health rela-tionship was also moderated by urbanicity. In Wheeler et al.’s (2015) study, Shannon Diversity of land cover types had the strongest association with good health for
M. R. Marselle et al.
195
individuals who lived in rural areas, whilst, conversely, bird species richness had the strongest positive effect on health for those who lived in urban areas. Carrus et al. (2015) found a high level of biodiversity was more strongly associated with well- being in urban green spaces than in peri-urban areas suggesting that higher biodi-versity is more important in urban areas for well-being. Other contextual variables, such as living near to the coast (White et al. 2017), had no moderating effect.
Table 9.3 Level of biodiversity investigated by the type of contact with biodiversity investigated in the 16 studies published after 2012
Type of contact with biodiversityBiodiversity levels Direct Indirect Unspecified
Ecosystem/habitats
Green spaces (Carrus et al. 2015)
Forest biotopes (Johansson et al. 2014)
Margalef Diversity Index (Duarte-Tagles et al. 2015)Protected area designation (Saw et al. 2015)Scania Green Score (Annerstedt van den Bosch et al. 2015)Shannon Diversity Index (Wheeler et al. 2015; Rantakokko et al. 2018)
Species communities
Species richness Birds, plants/trees, and butterflies (Marselle et al. 2016; Marselle et al. 2015)
Animals/plants (White et al. 2017)
Birds in the morning, and birds in the afternoon (Cox et al. 2017)
Plants, birds, mammals and reptiles/amphibians (Foo 2016)
Fish/crustaceans (Cracknell et al. 2016, 2017)
Birds (Wheeler et al. 2015)
Trees and birds (Wolf et al. 2017)
Abundance a specific taxonomic group
Fish/crustaceans (Cracknell et al. 2017)
Birds in the morning, and birds in the afternoon (Cox et al. 2017)
Single species
Emerald ash borer (Agrilus planipennis), which is responsible for biodiversity loss of North American ash trees (Fraxinus spp.) (Jones 2017)
Total 4 5 7
Note. ‘Direct’ and ‘indirect’ contact with nature categories based on Keniger et al. (2013). Biodiversity levels are based on Botzat et al. (2016). Data in the cells identifies the specific biodi-versity variable assessed in each study; no data in a cell means no studies investigated that biodi-versity level and type of contact with the biodiverse environment. Biodiversity variables with a slash (‘/’) are a combined variable where the investigator did not separate out the contribution of each taxon; two taxa are analysed together
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9.3.1.8 Mediation Analyses
Mediators were explored in 3 studies (Carrus et al. 2015; Foo 2016; Marselle et al. 2016). Investigated mediators fell within two of the three domains mentioned by Markevych et al. (2017): ‘restoring capacities’ (perceived restorativeness (Carrus et al. 2015; Foo 2016; Marselle et al. 2016)) and ‘building capacities’ (physical activity and social interaction (Foo 2016)). ‘Reducing harm’ mediators were not investigated in these studies. Perceived restorativeness was found to mediate the relationship between biodiversity of green space and general well-being (Carrus et al. 2015), and between perceived bird species richness and positive affect, happi-ness and negative affect (Marselle et al. 2016). Perceived bird species richness also had an indirect effect on positive affect and happiness via the restorative compo-nents of being away, fascination and compatibility, and an indirect effect on nega-tive affect via compatibility (Marselle et al. 2016). Foo (2016) conducted path analyses to determine how spending time in forest environments with different lev-els of biodiversity influenced mental health and general well-being. Multiple medi-ating pathways were found; time spent in a forest environment with intermediate or high biodiversity engendered a sense of being away, which was positively associ-ated with a change in mood, which then was related to mental health. In only the high biodiverse forest was mental health related to general well-being. In the inter-mediate biodiverse forest, physical activity mediated the relationships between being away and mental health and general well-being. Social interaction did not mediate the effect of a forest environment on either outcome.
9.3.2 Synthesis of the Results from the Combined Published Literature on Biodiversity and Mental Health and Well- being Relationships
A combined set of 24 studies were included in the synthesis of results pertaining to the influence of biodiversity and mental health and well-being: 15 of the 16 recently published studies identified through our search process and nine of the 16 studies identified in Lovell et al. (2014). Fourteen of these 24 studies reported one or more positive associations between biodiversity and mental health or well-being outcomes (Carrus et al. 2015; Cox et al. 2017; Cracknell et al. 2017; Dallimer et al. 2012; Foo 2016; Fuller et al. 2007; Huby et al. 2006; Johansson et al. 2014; Jones 2017; Luck et al. 2011; Marselle et al. 2016; Rantakokko et al. 2018; Wheeler et al. 2015; White et al. 2017; Wolf et al. 2017) (see Table 9.4). Seventeen of the 24 studies reported one or more results with no significant relationship (Annerstedt van den Bosch et al. 2015; Annerstedt et al. 2012; Björk et al. 2008; Cox et al. 2017; Cracknell et al. 2016, 2017; Dallimer et al. 2012; de Jong et al. 2012; Duarte-Tagles et al. 2015; Fuller et al. 2007; Grahn and Stigsdotter 2010; Jorgensen et al. 2010; Marselle et al. 2015, 2016; Rantakokko et al. 2018; Saw et al. 2015; Wolf et al. 2017). Two studies reported one or more negative associations between biodiversity and mental health or well-being outcomes (Dallimer et al. 2012; Marselle et al. 2015) (Table 9.4).
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Tabl
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4 T
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res
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oss
all 2
4 st
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ter
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cant
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b
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atur
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6)L
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tudi
nal c
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016)
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nt
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Biodiversity levels were not equally covered by the 24 studies (see Fig. 9.4). Fifteen studies assessed biodiversity at the ecosystem/habitat level, with clear decreases to the single species level. However, the number of studies investigating biodiversity at these other levels has increased since Lovell et al. (2014).
9.3.2.1 Pattern of Results
To identify patterns in the results, we examined studies by biodiversity level and mental health and well-being outcomes (Table 9.5). We also identified the specific biodiversity variable that was measured (e.g. habitat types, birds) next to each result. The purpose was to gain insight into when biodiversity influences mental health and well-being and when it does not.
Mental Health and Well-being Outcomes
We started by looking at the results by outcome measure to determine if either out-come was more influenced by biodiversity. Nine studies investigated mental health outcomes, the majority of which were published after 2012, demonstrating a growth area for the field since Lovell et al. (2014). Mental well-being was investigated in 19 of the 24 studies. Two-thirds of the results (65%) pertaining to the influence of
15
10
5
0
Number of studies since Lovell et al. (2014) Number of Lovell et al. (2014) studies
Ecosystem/Habitat
Speciesrichness
Perceived speciesrichness
Single speciesAbundance
Cumulative number of studies by biodiversity level
Fig. 9.4 Biodiversity levels addressed by the 24 studies on the mental health and well-being effects of biodiversity. The sum may exceed 100% because studies address more than one level of biodiversity
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Table 9.5 Pattern of results by biodiversity levels and mental health and well-being indicator (n = 24 studies)
Outcome variableBiodiversity levels Mental health Mental well-being
Ecosystems/habitats
Annerstedt van den Bosch et al. (2015) (o) Scania Green Score
‘Lush, rich in species’Annerstedt et al. (2012)a
(o) Scania Green Score ‘Lush, rich in species’
Duarte-Tagles et al. (2015) (o) Margalef Diversity of
eco-regionsRantakokko et al. (2018) (o) Shannon Diversity of
land use
Bjork et al. (2008)a
(oo) Scania Green Score ‘Lush, rich in species’
Carrus et al. (2015) (++b) Green spacesDallimer et al. (2012)a
(ooo) Shannon Diversity of habitat types
(+++) Tree coverDe Jong et al. (2012)a
(o) Scania Green Score ‘Lush, rich in species’
Fuller et al. (2007)a
(+++o) Number of habitat types (oooo) Tree coverGrahn & Stigsdotter (2010)a
(o) Scania Green Score ‘Lush, rich in species’
Johansson et al. (2014) (+) Forest biotopesc
Jorgensen et al. (2010)a
(o) Green spacesLuck et al. (2011)a
(+) Vegetation cover (+) Vegetation densityRantakokko et al. (2018) (+) Shannon Diversity of land
useSaw et al. (2015) (o) Protected areasWheeler et al. (2015) (++) Shannon Diversity of land
over
(continued)
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Table 9.5 (continued)
Outcome variableBiodiversity levels Mental health Mental well-being
Species communities
Species richness Cox et al. (2017) (ooo) Morning birds (ooo) Afternoon birdsHuby et al. (2006)a
(+) BirdsWolf et al. (2017) (+) Trees (+) Birds
Cracknell et al. (2016) (oo) Fish/crustaceansCracknell et al. (2017) (o) Fish/crustaceansDallimer et al. (2012)a
(+++) Birds (– – –) Plants (ooo) ButterfliesFuller et al. (2007)a
(++oo) Birds (++oo) Plants (oooo) ButterfliesLuck et al. (2011)a
(+) BirdsWheeler et al. (2015) (+o) BirdsWolf et al. (2017) (+o) Trees (+o) Birds
Perceived species richness Dallimer et al. (2012)a
(+++) Birds (+++) Plants/trees (+++) ButterfliesMarselle et al. (2016) (+++) Birdsb
(ooo) Plants/treesb
(ooo) Butterfliesb
Marselle et al. (2015) (–oo) Birds (ooo) Plants/trees (ooo) ButterfliesWhite et al. (2017) (+++) Animals/plants
Abundance of a specific taxonomic group
Cox et al. (2017) (ooo) Morning birds (+++) Afternoon birds
Cracknell et al. (2017) (+) Fish/crustaceansDallimer et al. (2012)a
(+++) BirdsLuck et al. (2011)a
(+) Birds
(continued)
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biodiversity on mental health were non-significant. About half of the results (49%) showed non-significant relationships between biodiversity and mental well-being. These findings suggest that the results are equally ambiguous for both mental health and mental well-being.
Ecosystems/Habitats
Sixteen studies investigated the impact of biodiversity at the ecosystem/habitat level on mental health and well-being (Table 9.5). All 4 of the studies that assessed the influence of ecosystem/habitat biodiversity on mental health were non-significant (Annerstedt van den Bosch et al. 2015; Annerstedt et al. 2012; Duarte-Tagles et al. 2015; Rantakokko et al. 2018).
Results were mixed for the 12 studies that investigated the impact of biodiversity at the ecosystem/habitat level on mental well-being. Positive relationships were found for Shannon Diversity Index of land cover and land use, and mental well- being; more biodiverse ecosystems/habitats were positively associated with greater quality of life (Rantakokko et al. 2018) and good health (Wheeler et al. 2015), and negatively associated with poor health (Wheeler et al. 2015). Non-significant results for Shannon Diversity Index of habitat types were found (Dallimer et al. 2012). Greater vegetation cover and density of vegetation cover were associated with greater life satisfaction (Luck et al. 2011). Number of habitat types was associated with greater reflection and distinct identity (Fuller et al. 2007). Tree cover was posi-tively associated with greater reflection, continuity with the past and attachment in Dallimer et al. (2012), but was non-significant in Fuller et al. (2007). A significant non-linear trend of forest biotope on positive affect was also found; intermediate biotope was rated the most positive followed by the high biotope and the low bio-tope (Johansson et al. 2014). Carrus et al. (2015) found biodiversity of different
Table 9.5 (continued)
Outcome variableBiodiversity levels Mental health Mental well-being
Single species
Jones (2017) (+)d Ash trees
Jones (2017) (+)d Ash trees
Note. Papers may be included more than once, if variation in individual results. Biodiversity levels are based on Botzat et al. (2016). Biodiversity variables with a slash (‘/’) are a combined variable where investigator did not separate out the contribution of each taxon; two taxa are analysed together. Each –, o or + symbol represents the direction of each individual result reported in the paper. – = significant negative relationship; o = non-significant relationship; + = significant posi-tive relationshipaStudy from Lovell et al. (2014)bMediation analysiscEffect was greatest in the medium biotope, followed by the high and then the low biotopesdInverse relationship
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green spaces had a significant direct, and indirect, effect on general well-being. Individuals in the high biodiversity condition had greater general well-being scores than individuals in the low biodiversity condition, and perceived restorativeness mediated the relationship between biodiversity and well-being (Carrus et al. 2015). Studies assessing ecosystems/habitats by Scania Green Score ‘lush, rich in species’ (Björk et al. 2008; de Jong et al. 2012; Grahn and Stigsdotter 2010), protected areas (Saw et al. 2015) and green space types (Jorgensen et al. 2010) on mental well- being were all non-significant.
Species Richness
Ten studies examined the effect of species richness (Table 9.5). Three of these inves-tigated the influence of species richness on mental health, with mixed results. Huby et al. (2006) found positive associations between mental health and greater bird species richness. Similarly, Wolf et al. (2017) found that participants in the high species rich conditions of trees and birds, reported less anxiety, compared to partici-pants in the low species rich conditions. However, Cox et al. (2017) found no influ-ence of morning and afternoon bird species richness on depression, anxiety or stress.
Across the 7 studies that measured mental well-being just over half of results (55%) were non-significant. Specifically, there was no difference in positive affect and arousal between low and high species richness conditions of fish/crustaceans (Cracknell et al. 2016). Additionally, species richness of fish/crustaceans had no effect on happiness, when species abundance was held constant (Cracknell et al. 2017). There was also no difference in vitality scores between the high and low spe-cies richness conditions of birds and trees (Wolf et al. 2017). However, for positive affect, participants reported higher levels in the high species richness conditions of trees, and birds, compared to low species richness conditions (Wolf et al. 2017). Bird species richness was positively associated with good health (Wheeler et al. 2015). However, the negative association between bird species richness and poor health did not hold when accounting for covariates (Wheeler et al. 2015). Butterfly species richness had no significant effect (Dallimer et al. 2012; Fuller et al. 2007), and plant species richness had a negative effect, on psychological well-being (Dallimer et al. 2012). Greater species richness of birds (Dallimer et al. 2012; Fuller et al. 2007; Luck et al. 2011) and plants (Fuller et al. 2007) were both associated with greater mental well-being.
Perceived Species Richness
No study investigated the effect of perceived richness on mental health (see Table 9.5). Four studies examined the influence of perceived species richness on mental well-being. Just over half of the results (53%) demonstrated a positive effect.
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White et al. (2017) found that greater perceived species richness of animals/plants was associated with more positive mood, arousal and recovery. Dallimer et al. (2012) found positive associations between perceived species richness of birds, but-terflies and plants/trees and psychological well-being (measured as reflection, con-tinuity with the past and attachment). Using the same perceived species richness variables, Marselle et al. (2015, 2016) found no associations between perceived plant/tree and butterfly species richness and emotional well-being; perceived bird species richness had no influence on positive affect and happiness but was associ-ated with an increase in negative affect (Marselle et al. 2015). An indirect effect of perceived bird species richness on positive affect, happiness and negative affect through perceived restorativeness was also found (Marselle et al. 2016). Bird biodi-versity was associated with greater perceived restorativeness, which was in turn associated with greater positive affect and happiness, and reduced negative affect.
Abundance of Specific Taxonomic Groups
Abundance was investigated in 4 studies (see Table 9.5). One study examined the impact on mental health, with mixed results. Cox et al. (2017) found that afternoon, but not morning, bird abundance was associated with less depression, anxiety and stress. The reason for this difference for mental health, according to Cox et al. (2017), is that afternoon abundance is a measure of the number of birds that people are likely to experience, as opposed to a measure of the total number of birds that are actually there. Three studies investigated the influence of the abundance of spe-cific taxonomic groups on mental well-being, all with positive results. Bird abun-dance was positively associated with reflection, continuity with the past and attachment (Dallimer et al. 2012) and life satisfaction (Luck et al. 2011). Greater abundance of fish/crustaceans, viewed in photographs, was related to greater reported happiness, when species richness was held constant (Cracknell et al. 2017). This suggests that it may be the quantity of fish/crustaceans, and not the number of species per se, that influences happiness.
Single Species
One study assessed the effect of biodiversity loss by investigating the decline of a single species, the North American ash tree following infestation by the invasive emerald ash borer, on mental health and well-being (Jones 2017). The loss of ash trees, 5 years after initial infestation, was associated with an increase in depression, as well as a decrease in life satisfaction. The results suggest the negative influence that biodiversity loss could have on mental health and well-being.
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9.4 Discussion
This chapter identifies, summarises and synthesises research on the impact of biodi-versity on mental health and mental well-being. This was done by identifying and describing the body of evidence, published since Lovell et al.’s (2014) systematic review, relating biodiversity to mental health and well-being, and by synthesising results from the studies identified by both Lovell et al. (2014) and in this chapter.
Sixteen primary research studies met our inclusion criteria. The assessment of biodiversity in these recently published studies has improved, compared to the stud-ies reviewed in Lovell et al. (2014). Four studies in Lovell et al.’s (2014) review did not directly assess biodiversity (Barton et al. 2009; Curtin 2009; Lemieux et al. 2012; Pereira et al. 2005). The growing availability of biodiversity-focused studies meant that all 16 studies identified for our updated review considered the diversity of the environment in some way. Additionally, the recent body of literature investi-gates a greater variation of the biodiversity at the species community and single species levels. Further, the number of studies investigating mental health has grown since Lovell et al. (2014).
Our synthesis of the combined set of 24 studies (nine from Lovell et al. (2014) and 15 identified in this Chapter) was conducted to describe the body of literature focused on mental health and well-being as an outcome. There is some evidence to suggest that biodiverse natural environments may be associated with good mental health and well-being. Fourteen of these studies showed one or more positive rela-tionships manifested as either better mental health or mental well-being. Positive relationships were found across all, but one, study designs. Positive relationships were most evident when assessing species abundance and mental well-being rela-tionships. However, 17 of these studies reported one or more non-significant find-ings. Non-significant effects were found across all study designs, and were most evident when assessing impact of biodiversity at the ecosystem/habitat level on mental health. There was some evidence of negative relationships (in 2 of the 24 quantitative studies). Overall, the body of evidence across these 24 studies is not yet of the extent necessary to characterise the role of biodiversity in relation to mental health and/or mental well-being. Variation in the evidence may relate to the level at which biodiversity is investigated, how the biodiversity data are collected, and which taxonomic groups are explored. These raise issues for cross-study comparability.
The synthesis of results suggests that abundance of specific taxonomic groups may be an important variable. Abundance of a taxonomic group may be more noticeable by people than the number of species (Dallimer et al. 2012). As such, it may not be the number of different species (i.e. species richness) that matter, but the total number of animals, plants or birds (i.e. abundance). Indeed, Cracknell et al. (2017) found differential results between species richness and abundance on mental well-being; only abundance was related to happiness, but not species richness. Similar results were found elsewhere (Hedblom et al. 2017).
Clear gaps in the research were also found. None of the 24 studies investigated the effect of perceived species richness on mental health. Another possible area of inves-tigation, not assessed in any of the 24 studies, is participants’ perception of the abun-dance of a specific taxonomic group on mental health and/or mental well-being.
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Lovell et al. (2014) provided a number of recommendations for future research, which were to improve study design, and specify the type of contact and frequency of exposure to biodiversity, and test for moderating and mediating variables. Most of the recently published studies were cross-sectional; a similar observation made by Lovell et al. (2014). However, the number of robust research designs (experi-mental, natural experimental, longitudinal), as well as quasi-experimental and before-and-after repeated measures studies has increased, reflecting the call for improved study designs. Additionally, 2 studies sought to examine impacts of changes in biodiversity on mental health and well-being outcomes, which is an increase from Lovell et al. (2014), which had no such studies. Regarding contact with biodiversity, more than half of the recently published studies explicitly investi-gated direct and indirect contact, thus heeding Lovell et al.’s (2014) call to investi-gate how type of contact with the biodiverse environment may influence outcomes. However, no studies have yet heeded Lovell et al.’s (2014) call for investigations of frequency of exposure to biodiversity. Four of the identified 16 studies investigated moderators that qualified the biodiversity and mental health and well-being rela-tionship. Three of the recently published studies conducted mediation analyses to determine the mechanisms through which biodiversity affects mental health and/or well-being. These few moderator and mediator studies are nevertheless an increase from those reported in Lovell et al. (2014).
9.4.1 Concluding Observations
In conclusion, we provide some thoughts to guide future research:
Better IntegrationBy its nature, the questions considered within this field of inquiry are interdisciplin-ary and thus by necessity require integration of natural, social and health sciences. Future research should be interdisciplinary as this will improve measurement of biodiversity, mental health and well-being.
Research DesignWe encourage researchers to consider more robust designs such as before-and-after comparison studies, as well as to take advantage of natural experiment situations, and to consider development of integrative mixed method studies. Experimental studies, which test short-term effects, are particularly suited for assessing changes in momentary mental well-being. Future reviews of the influence of biodiversity and health could include a statistical meta-analysis to address the limitations from vote-counting reported here and in Lovell et al. (2014). Qualitative research designs could help identify what aspects of biodiversity people attend to, and what experi-ences this creates. This information could help to unravel the process by which biodiversity affects mental health and well-being.
Biodiversity AssessmentWe encourage future research to use well accepted approaches for measuring biodi-versity in the field or from secondary data, such as those used in the ecological
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literature. The synthesis presented here indicates that different metrics of biodiver-sity (e.g. species richness; abundance) could play a role and should, therefore, have their relationships with mental health and well-being assessed separately. Functional aspects of biodiversity, such as phenotypic diversity (colour of fish, height of trees) (Botzat et al. 2016) and charismatic species (Dallimer et al. 2012) could also be usefully explored. Further, studies should also measure the biodiversity that is expe-rienced by people, as opposed to the objectively measured diversity in an environ-ment. The bird hiding in a bush, or the nocturnal mammal, that is not seen nor heard, is unlikely to be experienced by humans, and unlikely to influence mental health or well-being (Bell et al. 2014; Cox et al. 2017). Assessments of the biodiversity that people perceive or experience can be captured with Global Positioning System (GPS) trackers, eye-tracking technology and mobile electroencephalography (EEG) devices. We also recognise that one’s perception of biodiversity is important for health and well-being. The synthesis presented here demonstrated that perceived species richness is associated with mental well-being. Future studies could investi-gate perceived species richness-mental health relationships. Further, whilst not investigated in any of the studies reviewed here, perceived biodiversity could also be investigated to assess whether it mediates the effect of objectively measured biodi-versity on mental health and/or well-being. See de Vries and Snep Chap. 8, this volume, for further discussion on biodiversity measurement considerations.
Mental Health and Well-being AssessmentTo facilitate cross study comparison, we encourage future research to use validated scales of mental health and well-being that have been used previously in psychol-ogy and health.2 As such, researchers may wish to consider the reliability of using a mental health or well-being measure for understanding the biodiversity-health rela-tionship. When developing new measures, theoretically grounded outcome mea-sures are essential.
TheoryFuture studies should articulate the theoretical framework(s) they are using to hypothesise about biodiversity-health relationships (see also Marselle Chap. 7, this volume). Researchers should use theory to drive the selection of outcome measures and identify mediators, moderators and confounders. To our knowledge, no study has investigated the effect of biodiversity on attention restoration, and more studies could investigate stress as an outcome measure; both of which explicitly test theo-ries of restorative environments. Additionally, theories on the relationship of natural environments on health, such as Attention Restoration Theory could be developed further, e.g. by differentiating general effects of natural environments, and specific aspects of biodiversity, on health aspects.
MechanismsFuture studies should continue to investigate the mediators of biodiversity and men-tal health and well-being using the pathways identified in nature-health frameworks (Hartig et al. 2014; Markevych et al. 2017).
2 Researchers may wish to see Linton et al. (2016) for a list of such measures.
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ModeratorsFuture studies should continue to investigate personal and contextual factors as moderators (Markevych et al. 2017) of biodiversity-mental health and well-being relationships.
Dose-Response RelationshipsNone of the studies examined dose-response relationships of biodiversity on mental health and well-being. At present, we do not know how much biodiversity is required for an effect, how long before effects take place, or how long they last. For example, future studies could usefully investigate the amount of time spent in the biodiverse environment required for a change in mental health or well-being.
Acknowledgements Thanks are due to Professor Zoe Davies and Professor Aletta Bonn for their comments on an earlier draft of this manuscript, the three peer reviewers, and to Popay et al. (2006) for permission to use the ESRC-funded Narrative Synthesis guidance. Dr. Martens’ involvement was supported through funding from the Federal Agency for Nature Conservation, Germany. Dr. Irvine’s involvement was supported through funding from Rural & Environment Science & Analytical Services Division of the Scottish Government. Dr. Dallimer’s involvement was supported by the UK government’s Natural Environment Research Council (NERC) grant number NE/R002681/1.
Appendix: Search Terms Used in Web of Science
Search terms used
Number of references found
#01 Biodiversity OR ‘species richness’ OR ‘protected area*’ AND ‘mental health’ OR ‘mental well-being’ OR ‘social cohesion’ OR ‘social well-being’ or ‘physical activity’ TS = (biodiversity OR ‘species richness’ or ‘protected area*’) AND TS = (‘mental health‘ OR ‘mental well-being’ OR ‘social cohesion’ OR ‘social well-being’ or ‘physical activity’) AND DOCUMENT TYPES: (Article). Timespan: 2013–2017. Indexes: SCI-EXPANDED, SSCI, A&HCI, ESCI.
79
#02 biodiversity AND ‘mental health’ 23#03 biodiversity AND ‘mental well-being’ 3#04 ‘species richness’ AND ‘mental health’ 5#05 ‘species richness’ AND ‘mental well-being’ 1#06 ‘protected area’ AND ‘mental health’ 1#07 ‘protected area’ AND ‘mental well-being’ 0#08 biodiversity AND ‘physical activity’ 39#09 ‘species richness’ AND ‘physical activity’ 6#10 ‘protected area’ AND ‘physical activity’ 3#11 ‘protected area’ AND ‘social cohesion’ 4#12 ‘protected area’ AND ‘social well-being’ 2#13 biodiversity AND ‘social cohesion’ 16#14 ‘species richness’ AND ‘social cohesion’ 0#15 ‘species richness’ AND ‘social well-being’ 0#16 biodiversity AND ‘social well-being’ 4
Total references 189
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